2/19 Toby's PMPS=342 +2=300 +5=143+7.5=130

Status
Not open for further replies.
Peg and Toby

Peg and Toby

Member Since 2014
I gave 16.5 units of Lev. and .5 R this morning. I don't know if I am using the R right or not. I was looking at Suki and Crystal's condo and I don't know if the way that I'm using it is wrong or not. I am quite confused on how to use it. I also don't know what the cut off point should be. Julie thought 250.
Would be grateful if someone could look at Toby's ss and tell me what they thought.
Thanks, Peg and Toby
 
It looks to me like the 0.5uR is bringing Toby down more than 100 points, which might be more than you want it to. You want the Lev to be providing most of the action and the R to just be tweaking.

For example, looking at 2/17, with no R in the am, Toby only dropped 52 points from amps to +3, which seems to be fairly typical for him.
That evening, with 0.5uR he dropped 139 points by +2.

Today he's dropped 92 points by +2 with the 0.5uR.

Overall, his ss is looking pretty good, however. The thing to be aware of is that if the R drops him too fast, it can cause a bounce in response. Then he may be higher at the next shot time than he otherwise would've been. It can become a viscious cycle. I don't think you're in that at this point, I'm just mentioning it for you to be aware of. Most of the time people think in terms of moving the cat 50-100 points max - the goal being to lower the blood sugar so that the Lev can work better. Both Lantus and Lev do much better controlling lower blood sugar than high blood sugar.

Using R is a bit of an art - we don't have an exact formula that fits every cat. But I think you are doing fine overall. You're seeing blue almost every cycle with him, which is pretty good. Let's tag @Sandy and Black Kitty and see if she has some thoughts to suggest for you.

As far as your Lev dose, I would increase it and let it do most of the heavy work on the blood sugar for you. When you get to the point that you're depending on R to have those blue numbers, that's a good indicator (to me, at least) that you need to increase the Lev. When you're increasing, consider that the protocol suggests a 0.25u increase on a 1.0-3.0u dose. That's an increase of 8%-25%. At 16.5u, a comparable increase is 1.32u-4.1u. Double-check my math but i think that's correct. I think in terms of a 10% - 25% increase, depending on how much you need to move the kitty's BGs. In Toby's case, right now, he's got a lot of blues so I would think more along the lines of 10% increases, so perhaps moving him from 16.5u to 18u (increase of 1.5u, just less than 10%).

When you increase the Lev, I'd hold off on the R so that you don't give a double-whammy that you didn't mean to give!

Anyway, that's something for you to consider.
 
Julie's great, isn't she. Sure got me and Polly through some confusing times with my big gulper.

julie & punkin (ga) said:
Using R is a bit of an art
Click to expand...

I know nothing about it (Polly's top dose was 10.5U and we did the SRT so she's come down quite a bit). But I really watch in awe as you and Suki "go to school" with R used to bring numbers down so Lev can kick in and do its work.

Fascinating. Such promise. Such a good bean.

Marilyn and Polly
 
I went with Julie's advice and went up to 18 units of Lev. Didn't give any R. Come on Toby
work this dose increase. Keep hoping we will hit that magic number. Will monitor tonight and see how we make out. Take Care, Peg and Toby
 
Good luck with the increase - I hope it's got a little magic in it. I too never used R - there wasn't anyone available to help who had with high dose experience in R when we could have really used it. So I too am watching and learning.
 
Hi there :cool:

I've just pulled up Tobys ss and have a housekeeping request (one that applies to everyone)-
Please remove color from any cells that do not contain BG test result numbers.
The ss should reflect reality - blanks included. No data - no color.
Thanks in advance! :cool:

Peg and Toby said:
I don't know if I am using the R right or not. I was looking at Suki and Crystal's condo and I don't know if the way that I'm using it is wrong or not. I am quite confused on how to use it. I also don't know what the cut off point should be. Julie thought 250.
Click to expand...
Julie covered the bases well .
Remember the old 'Etch a Sketch' drawing toy? If you wanted a horizontal line you would twist the Left knob and for a vertical line the Right knob. Easy.

Drawing a diagonal or curve however, required you use both the L & R knobs simultaneously but not necessarily equally, until you achieve the desired effect. Not so easy.

That takes practice. Especially if you are in the back seat of your parents car while they are driving up and down hills with curving unfamiliar roads that can change in ways that are not entirely predictable. Like BGs can be, particularly with high dose conditions.

The picture you want to emerge is overall a horizontal line, one in the safest BG range possible. For that you need the L to be predominant.
Since it can take time to so safely increase L to the optimum dose, the R can make sure the numbers don't try and sneak back up out of line..

I'm glad you increased the L. I recommend that before you shoot R again, pause and give the new L dose a couple 2, 3 cycles (maybe more depending on the numbers) to see what it can or can't do. Then re-evaluate.

Toby and Crystal are a good example of ECID . Although they are both high-dose they are very "D".
Toby saw green 16 days after starting insulin - and it was an AMPS!
In contrast three months of methodical increases to the current 26u dose and Crystal has yet to see blue..

You are doing just fine Peg, Using R successfully requires a light touch not to mention patience, perseverance and study of your results.
 
Status
Not open for further replies.
Back
Top